MEDICARE: JEREMY J. KATZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	2003000613	MO

General Provider Information

NPI Number	:	1508848458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEREMY J. KATZ MD

Provider Business Mailing Address
First Line	:	10301 HICKMAN MILLS DR
Second Line	:	100
City	:	KANSAS CITY
State	:	MO
Zip	:	64137-1674
Country	:	US
Telephone Number	:	816-763-5446
Fax Number	:	816-763-8426

Provider Business Practice Location Address
First Line	:	17065 S 71 HWY
Second Line	:
City	:	BELTON
State	:	MO
Zip	:	64012-2165
Country	:	US
Telephone Number	:	816-763-5446
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2005
Last Update Date	:	07/08/2007

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